Disorganised attachment and reactive attachment disorder
This article provides a discussion on the issue of disorganised attachment, potential outcomes, and factors that put children at risk of subsequently developing Reactive attachment disorder (RAD). Theoretical background Disorganised attachment is the one of three insecure patterns of attachment and constitutes a risk factor for a range of psychopathologies such as Reactive Attachment Disorder. It has been defined as the momentary breakdown of the usual organised attachment strategies. Organised attachments include the secure, and insecure (avoidant) and insecure (ambivalent) styles. It is thought to be caused by frightening or frightened parental behaviour, or loss or trauma in the parents (Main & Hesse 1990). Disorganized attachment represents an attachment disturbance (Ijzendoorn, Bajermans-Kranenburg and Juffer 2005). Disorganized attachment Carlson,et. al. (1989)Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1995). Finding order in disorganization: Lessons from research on maltreated infants’ attachments to their caregivers. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 135–157). NY: Cambridge University Press. found that 82% of maltreated children displayed disorganized/disoriented pattern of attachment, when measured using the Strange Situation procedure developed by Mary Ainsworth. Lyons-Ruth et al (1990) obtained figures of 55% among maltreated infants and 34% amongst low income controls (with clinical social work involvement). Lyons-Ruth, K., Connell, D., Grunebaum, H., & Botein, S. (1990) "Infants at social risk: Maternal depression and family support services as mediators of infant development and security of attachment". Child Development, 61 pp85-98 Children with histories of maltreatment, such as physical and psychological neglect, physical abuse, and sexual abuse, are at risk of developing severe psychiatric problemsGauthier, L., Stollak, G., Messe, L., & Arnoff, J. (1996). Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning. Child Abuse and Neglect, 20, 549–559. Malinosky-Rummell, R., & Hansen, D. J. (1993). Long-term consequences of childhood physical abuse. Psychological Bulletin, 114, 68–69.. These children are at risk of developing Reactive Attachment Disorder.Greenberg, M. (1999). Attachment and psychopathology in childhood. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment (pp. 469–496). NY: Guilford Press. Lyons-Ruth, K., & Jacobvitz, D. (1999). Attachment disorganization: Unresolved loss, relational violence and lapses in behavioral and attentional strategies. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment (pp. 520–554). NY: Guilford Press.. These children may be described as experiencing trauma-attachment problems and are likely to develop Reactive Attachment DisorderHowes, P., & Cicchetti, D., (1995). In Cicchetti, D., & Toth, S., (Eds.) (1995), Child Abuse, Child Development and Social Policy: Advances in Applied Developmental Psychology, volume 8, Norwood, NJ: Ablex. pp.249-299., which is a psychiatric diagnosis. The clinical formulation of Complex post traumatic stress disorder is a clinical perspective on this set of problemsCook, A.; Blaustein, M.; Spinazzola, J.; and van der Kolk, B., (2003) Complex trauma in children and adolescents. White paper from the National Child Traumatic Stress Network Complex Trauma Task Force. The trauma experienced is the result of abuse or neglect, inflicted by a primary caregiver, which disrupts the normal development of secure attachment. As was mentioned earlier, such children are at risk of developing a disorganized attachment Lyons-Ruth, K., & Jacobvitz, D. (1999). Attachment disorganization: Unresolved loss, relational violence and lapses in behavioral and attentional strategies. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment (pp. 520–554). NY: Guilford Press. Solomon, J. & George, C. (Eds.) (1999). Attachment disorganization. NY: Guilford Press. Main, M., & Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorganized attachment status. In M. T. Greenberg, D. Ciccehetti & E. M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161–184). Chicago: University of Chicago Press.. Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1995). Finding order in disorganization: Lessons from research on maltreated infants’ attachments to their caregivers. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 135–157). NY: Cambridge University Press., as well as depressive, anxiety, and acting-out symptoms Lyons-Ruth, K. (1996). Attachment relationships among children with aggressive behavior problems: The role of disorganized early attachment patterns. Journal of Consulting and Clinical Psychology, 64, 64–73. Lyons-Ruth, K., Alpern, L., & Repacholi, B. (1993). Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom. Child Development, 64, 572–585.. References Category:Attachment See also *Attachment in children *Attachment theory *Bowlby *Mary Main *Mary Ainsworth